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Influenza (Flu) Vaccine (Inactivated or Recombinant): 'What You Need to Know'
From the Document: "Influenza ('flu') is a contagious disease that spreads around the United States every year, usually between October and May. Flu is caused by influenza viruses, and is spread mainly by coughing, sneezing, and close contact. Anyone can get flu. Flu strikes suddenly and can last several days. [...] Flu can also lead to pneumonia and blood infections, and cause diarrhea and seizures in children. If you have a medical condition, such as heart or lung disease, flu can make it worse."
Centers for Disease Control and Prevention (U.S.)
2015-08-07
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Pandemic Impacts to Lifeline Critical Infrastructure
From the Scope: "The Department of Homeland Security's Office of Cyber and Infrastructure Analysis (DHS/OCIA) produces Critical Infrastructure Security and Resilience Notes in response to changes in the infrastructure protection community's risk environment from terrorist attacks, natural hazards, and other events. This note examines the impact of a pandemic on lifeline critical infrastructure at the local, regional and national level, including the effects of absenteeism on these sectors. This note also reviews the potential economic impacts resulting from a pandemic and procedures for mitigating the impact of a pandemic. This note supports DHS leadership, the DHS Protective Security Advisors, and other Federal, State, and local agencies. This product was developed in coordination with the DHS Office of Health Affairs, the DHS National Protection and Programs Directorate's Office of Infrastructure Protection, the Department of Health and Human Services (HHS), and the Department of Energy (DOE)."
United States. Department of Homeland Security
2015-07-30
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Middle East Respiratory Syndrome (MERS-CoV): World Health Organization Responses [July 2, 2015]
"In September 2012, Middle East Respiratory Syndrome coronavirus (MERSCoV) was first identified in Saudi Arabia and has spread to more than one dozen countries (Figure 1). MERSCoV is an infectious respiratory disease that can be fatal. There is no vaccine or specific treatment for the disease, but the treatment of symptoms, which can include fever, cough, and shortness of breath, may improve patient outcomes. Over 1,300 cases have been reported to the World Health Organization (WHO) since 2012. Roughly 36% of reported cases have resulted in deaths. On May 20, 2015, a MERSCoV outbreak began in the Republic of South Korea (ROK). As of June 30, 2015, the World Health Organization (WHO) has associated 182 cases (including one in China and one in Thailand) with this outbreak, including 33 deaths."
Library of Congress. Congressional Research Service
Salaam-Blyther, Tiaji
2015-07-02
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Role of Superspreading in Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Transmission
From the Document: "As at 15 June 2015, a large transmission cluster of Middle East respiratory syndrome coronavirus (MERSCoV) was ongoing in South Korea. To examine the potential for such events, we estimated the level of heterogeneity in MERS-CoV transmission by analysing data on cluster size distributions. We found substantial potential for superspreading; even though it is likely that R0 < 1 overall, our analysis indicates that cluster sizes of over 150 cases are not unexpected for MERS-CoV infection."
Eurosurveillance
Kucharski, Adam (Mathematician); Althaus, Christian L.
2015-06-25
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Bayesian Closed Point of Dispensing Planning Model
"The goal of this thesis is to assist a local public health department to plan for a mass medication closed Point of Dispensing (POD) in a large casino. The objective is to identify the best resource allocation for the stations in the POD in order to maximize the throughput considering uncertainty. The major unknown and uncertain factor affecting this critical decision is the traffic intensity. A Bayesian decision model is constructed to plan this closed POD site. […] The results show that the best resource allocation scenario is to allocate 6 nurses to the triage station, 9 casino staff to the registration station, 9 casino staff to the screening station and 12 nurses to the dispensing station. The ultimate goal of taking 3 minutes to process each person in the POD could not be achieved. In the recommended resource allocation scenario the minimum expected time per person is 4 minutes. In conclusion, the Bayesian decision analysis approaches used in this research can assist public health departments with determining the best resource allocation in POD stations. The models will also provide decision makers with insight about the traffic intensity of the system given the limited data available."
North Carolina State University
Aly, Heba Mohamad
2015-05-08
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Short Term Fixes, Long Term Consequences: Vaccines, Viruses, and Dollars [video]
From the Video Description: "On April 28, 2015, Big Cities Health Coalition leaders from four major metropolitan health departments that have tackled measles, Ebola, and other public health emergencies shared their experiences and highlighted what needs to be done at the federal level to adequately prepare for current and future crises. This was a Big Cities Health Coalition briefing, hosted by U.S. Representative Tom Price (R-IL) and U.S. Representative John Lewis (D-GA)." The duration of the video is 59 minutes and 56 seconds.
National Association of County & City Health Officials (U.S.)
2015-05-01
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Recommendations for Isolation Precaution Step Down and Discharge of Persons Under Investigation or Confirmed Ebola Virus Disease Patients
From the Preamble: "After someone who has been under investigation for Ebola Virus Disease (EVD) is determined not to be infectious, or after someone recovering from confirmed EVD is determined to no longer pose a risk to others, significant anxiety (both patient and societal) may occur regarding the patient's ability to infect others in the community. Therefore, the 'standing down' of isolation precautions, as well as preparation for discharge, requires an organized, systematic and evidence-based approach to ensure the patient, family and health care workers are protected at all times. The purpose of this document is to provide recommendations for two situations: a) In the case of a person under investigation - procedure for ruling out EVD and discharging the patient to the community; and b) In the case of a confirmed EVD patient who is recovering in hospital and determined to no longer pose a risk to others - procedures for standing down the strict isolation precautions, transferring the patient to another part of the hospital, or discharging the patient to the community."
British Columbia
2015-04-22
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Whom Do You Trust? Doubt and Conspiracy Theories in the 2009 Influenza Pandemic
From the Abstract: "The 2009 pandemic of H1N1 influenza led people around the globe to create narratives about the epidemic defined by the question of trust; these narratives ranged from true conspiracy theories to simply accounts in which mistrust and betrayal formed a motif. In particular, most of these narratives reflected a fear of capitalism and globalization, although in specific regions, other issues--such as religion--played a more central role. These stories were not unique to the H1N1 pandemic but rather have appeared with every contemporary outbreak of infectious disease. This paper will examine conspiracy theories and moral panics related to the H1N1 pandemic in different world regions to explore how the disease became associated with economic and social systems in these accounts."
Portland State University
Smallman, Shawn C.
2015-04
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Leadership in Times of Crisis: A Toolkit for Economic Recovery and Resiliency
From the Overview: "Economic developers serve as a vital bridge between the business community and the greater economic interests in the communities they serve. Many local, regional, and state governments turn to their publicly or privately funded economic development organizations and chambers of commerce (referred to throughout this toolkit as 'EDOs') to be the economic leaders, 'deal makers,' and visionaries for attracting new investment and supporting existing businesses. In these roles, EDOs sometimes find themselves unexpectedly called to action when there is a natural or manmade disaster and businesses are suddenly impacted. In such instances, economic developers often find that so much of the hard work they have contributed to grow their economies can be reversed."
International Economic Development Council
2015-03
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B.C. Ebola Virus Disease Transportation Policy
From the Purpose: "The purpose of this policy is to describe the approach to the transportation of a person under investigation for or a confirmed Ebola Virus Disease (EVD) patient within British Columbia. Due to the size and geographic complexity of the province and the inherent challenges associated with planning for the management and transportation of an EVD case, it is necessary to ensure that any transportation plan can safely and effectively manage the movement of EVD patients from anywhere within the province."
British Columbia
2015-02-27
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Recommendations for Environmental Services, Biohazardous Waste Management, and Food and Linen Management for Persons Under Investigation and Confirmed Cases of Ebola Virus Disease: Standard Operating Procedures
From the Introduction: "While the probability of a person with Ebola virus disease (EVD) in British Columbia is low, preparedness to ensure health care workers can safely and effectively care for patients is essential. Preparedness relies on clear clinical processes, appropriate personal protective equipment (PPE) supply and deployment, and appropriate training for staff in the processes and equipment. [...] This document lists the standard operating procedures (SOPs) - steps, principles, responsibility and materials required - for environmental services staff and to follow when performing cleaning and waste removal during/following treatment of persons under investigation (PUI) and confirmed cases of EVD. It has been developed by environmental services and infection control experts and should be read in conjunction with the 'Recommendations for Environmental Services, Biohazardous Waste Management, and Food and Linen Management for Persons under Investigation and Confirmed Cases of Ebola Virus Disease (EVD)' document."
British Columbia
2015-02-12
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B.C. Guidance on Environmental Management of Potential Ebola Contamination in Community Settings
From the Introduction: "This document is to provide guidance to public health authorities and contractors for environmental management in the event a person under investigation for, or a confirmed case of, Ebola virus disease (EVD) is symptomatic while in the community (home or public space) or primary health care settings (Public Health Agency of Canada, 2014). This document does not address hospital settings."
British Columbia
2015-02-02
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Best Practices in Ranking Emerging Infectious Disease Threats: A Literature Review
"The threat of serious, cross-border infectious disease outbreaks in Europe is a significant challenge in terms of emergency preparedness. Types of threats and the pathogens involved shift in response to changing factors such as climate change, global travel, immigration patterns, environmental degradation, and social inequalities. In order to effectively target the use of resources to manage the risks of outbreak, it is necessary to formulate rankings or prioritisation of human and/or animal pathogens."
European Centre for Disease Prevention and Control
2015-02
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MMWR: Morbidity and Mortality Weekly Report, January 30, 2015
The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC). [It] is the agency's primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. This issue of MMWR contains the following: "Outbreaks of Unexplained Neurologic Illness -- Muzaffarpur, India, 2013-2014"; "Fetal Alcohol Syndrome Among Children Aged 7-9 Years -- Arizona, Colorado, and New York, 2010"; "Tickborne Relapsing Fever -- United States, 1990-2011"; "Update on the Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection, and Guidance for the Public, Clinicians, and Public Health Authorities -- January 2015"; "Public Health Response to Commercial Airline Travel of a Person with Ebola Virus Infection -- United States, 2014"; "Effectiveness of Ebola Treatment Units and Community Care Centers -- Liberia, September 23-October 31, 2014"; "A Plan for Community Event-Based Surveillance to Reduce Ebola Transmission -- Sierra Leone, 2014-2015"; "Notes from the Field: Identification of a Taenia Tapeworm Carrier -- Los Angeles County, 2014"; "Notice to Readers: Changes in the Presentation of Infectious Disease Data in the National Notifiable Diseases Surveillance System -- January 2015"; and "QuickStats: Suicide Rates, by Mechanism of Injury -- National Vital Statistics System, United States, 1999-2013". Notifiable Diseases and Mortality Tables from this issue can be accessed at the following link [http://www.cdc.gov/mmwr/index2015.html]
Centers for Disease Control and Prevention (U.S.)
2015-01-30
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Serious Infectious Disease: Challenges for Security and Defence
From the 'About the Event' section on the Royal United Services Institute website: "Conflict and post-conflict zones create particular challenges for controlling and containing infectious disease. Damage to hospitals, the degradation of healthcare infrastructure, and the loss of skilled medical personnel during conflict creates an environment in which infectious disease can emerge and spread rapidly, while failed states and those still struggling to recover from recent conflict are ill-equipped to provide healthcare systems that meet the complex needs of their populations. In addition, peacekeeping and stabilisation forces, NGOs [non-governmental organizations] and international aid workers can inadvertently bring infectious diseases into communities when they are at their most vulnerable. […] In Syria, polio re-emerged and spread during a conflict that has disrupted the childhood vaccination programme. The strain responsible originates from Pakistan, where polio remains endemic in large part due to Taliban opposition to vaccination programmes. In West Africa, ebola spread rapidly through communities with little if any modern healthcare provision and a deep mistrust of government agencies following devastating civil wars. This conference, sponsored by the Science and Technology Facilities Council (STFC), will look at the cases outlined above with a view to identifying salient features and factors which are of a more general relevance. It will bring together a multidisciplinary audience to discuss future research requirements that will help to predict, mitigate and contain future outbreaks of serious infectious disease and ways to strengthen surveillance and response in regions where healthcare infrastructure is weak or damaged."
Royal United Services Institute for Defence Studies; Science and Technology Facilities Council (Great Britain)
2015
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Handbook for the Management of Public Health Events in Air Transport: Updated with Information on Ebola Virus Disease and Middle East Respiratory Syndrome Coronavirus
From the Executive Summary: "[T]his document draws on the scientific literature to provide substantive public health guidance on public health events related to air transport. It is not intended to be a technical, operational guideline. However, it will support the development of national or site-specific operational guidelines and standard operating procedures, as well as support other air transport initiatives and those developed by the aviation sector. This version also includes technical documents and lessons learned during the 2014-2015 outbreaks of Ebola virus disease (EVD) and Middle East respiratory syndrome corona virus (MERS-CoV)."
World Health Organization
2015
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Dynamics of Interorganizational Risk Management Networks During the 2015 MERS Response in South Korea
From the Summary: "Between May 20, 2015 and November 24, 2015 an outbreak of the Middle East Respiratory Syndrome (MERS) coronavirus in South Korea resulted in the deaths of 38 people, 186 cases of infection confirmed, and the quarantine of 17,000 people. While the Korean national government and agencies have the overall responsibility for the MERS response, it is unclear as to how the principal agency had to coordinate the joint efforts from all levels of governments. This report aims to examine the dynamics of risk management networks including public, private, and nonprofit organizations engaged in the MERS response in South Korea."
University of Colorado, Boulder. Natural Hazards Center
Kim, KyungWoo
2015
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Meta-Leadership Lessons from the 2009 H1N1 Pandemic: An NPLI Case History
"In March 2009, a new strain of influenza, H1N1, appeared in Mexico and spread to the United States. The first confirmed case was of a nine-year-old girl in Imperial County, California (March 30). By April 18, seven cases had been confirmed in the U.S. and influenza activity was reported in several states. On April 23rd, the Health Service of Canada confirmed that the strains in the U.S. and Mexico had the same genetic sequence. By April 28, confirmed cases were also reported in Canada, Spain, Israel, New Zealand and the United Kingdom indicating the likelihood of global spread of this novel virus. The next day, the World Health Organization (WHO) raised the pandemic threat level from 4 to 5, its second highest. As the CDC [Centers for Disease Control and Prevention] stood up its Emergency Operations Center, it found itself in an unusual lack of political leadership. With a recent change of administrations, the Secretary of Health and Human Services had neither been appointed nor confirmed and, in turn, neither were many permanent assistant secretaries (although the Assistant Secretary for Preparedness and Response had been held over from the previous administration to ensure continuity) nor was a permanent CDC director in place. Dr. Richard Besser (NPLI [National Preparedness Leadership Initiative] Cohort II) was serving as acting director of the CDC and found himself reporting on the situation initially to the HHS [Health and Human Services] Chief of Staff, the only political leader from the new administration in place, and ultimately directly to the President and his Cabinet."
Harvard University. National Preparedness Leadership Initiative
Marcus, Leonard J.; Dorn, Barry C.; Henderson, Joseph M. . . .
2015
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Herd Immunity and Immunization Policy: The Importance of Accuracy
From the Introduction: "Unlike vaccine science, appropriate vaccine policy does not have a clear, evidence-based answer. The best policy for any given country is a complex question, and reasonable minds can differ on whether any type of mandate is appropriate and what form such mandate should take. Any such debates, however, lose their value when the arguments are premised on inaccuracies both in law and in fact. In 'Herd Immunity and Compulsory Childhood Vaccination: Does the Theory Justify the Law?', Mary Holland and Chase E. Zachary criticize vaccine mandates-focusing on childhood immunization requirements for daycares and schools--claiming both that 'herd immunity' is unachievable and that voluntary programs will achieve a satisfactory result. The first claim is inaccurate, and the second is unsupported by the authors' analysis. While it is possible to plausibly oppose mandatory vaccination policies, Holland and Zachary fail to mount such a case. This critique proceeds as follows: Part I highlights one glaring flaw in Holland and Zachary's legal analysis, viz., misunderstanding the nature of society's duty to children, Part II explains why the authors' view of herd immunity is incorrect, and Part III highlights a critical analytical shortcoming in their discussion."
Hastings College of the Law
Reiss, Dorit Rubenstein
2015
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Managing Difficult Times
From the Document: "Certain times of the year are especially painful for a bereaved person. This handout designed to help manage these difficult times. Examples include the family holidays, especially the period between thanksgiving and new years day, the day of death, the deceased person's birthday, the bereaved person's birthday, a wedding anniversary after the loss of a spouse, the first day of school each year, mother's or father's day after the loss of a child, parent's anniversary or mother's or father's day after the loss of a parent. Or, if the deceased loved one especially enjoyed the fall, you might find that time of year especially difficult. The anniversary of becoming pregnant might be difficult for someone who has lost a child. The winter solstice might be hard for a person who lost a close friend with whom she had celebrated this date every year."
Center for Complicated Grief
Shear, M. Katherine
2015
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Emerging Viral Diseases: The One Health Connection: Workshop Summary
From the Description on The National Academies Press website: "In the past half century, deadly disease outbreaks caused by novel viruses of animal origin - Nipah virus in Malaysia, Hendra virus in Australia, Hantavirus in the United States, Ebola virus in Africa, along with HIV (human immunodeficiency virus), several influenza subtypes, and the SARS (sudden acute respiratory syndrome) and MERS (Middle East respiratory syndrome) coronaviruses - have underscored the urgency of understanding factors influencing viral disease emergence and spread. 'Emerging Viral Diseases' is the summary of a public workshop hosted in March 2014 to examine factors driving the appearance, establishment, and spread of emerging, re-emerging and novel viral diseases; the global health and economic impacts of recently emerging and novel viral diseases in humans; and the scientific and policy approaches to improving domestic and international capacity to detect and respond to global outbreaks of infectious disease. This report is a record of the presentations and discussion of the event."
National Academies Press (U.S.)
Choffnes, Eileen R.; Mack, Alison
2015
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Hospital Surge Evaluation Tool: User Manual for Controllers and Evaluators
From the Introduction: "The Surge Test is a user-friendly peer assessment tool that helps hospitals identify gaps in their surge planning through a no-notice drill. This training module provides a brief overview of the Surge Test, including its objectives, key features, and staff and resource requirements. Planning checklists at the end of the document can be used to track progress in completing needed tasks before the drill."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2014-12
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[Arizona] Governor's Council on Infectious Disease Preparedness and Response: Preliminary Report
From the Executive Summary of Council Report: "This report highlights the work of the Council to examine, develop, and implement a coordinated and comprehensive plan to ensure Arizona's public health infrastructure is prepared for the potential outbreak of infectious diseases and can respond rapidly to protect the health of Arizonans. The Council's work included an analysis of the healthcare and public health systems' readiness to handle a patient with infectious disease, an examination of the points where a patient might present and enter the healthcare system, where services would be needed, and finally, a series of recommendations designed to improve patient and community safety and strengthen the public health and healthcare infrastructure. Charge 1: Develop and implement a coordinated statewide plan to address potential outbreaks of infectious diseases, including Ebola Virus Disease (EVD), and ensure a rapid response that protects the health and welfare of Arizonans. […] Charge 2: Serve as a reliable and transparent source of information and education and strengthen collaboration among healthcare organizations, medical communities, government agencies, law enforcement, non-profit organizations, and the community-at-large in order to effectively address infectious disease transmission and treatment. […] Among the members of the council, there was broad consensus that the healthcare and public health infrastructure needs a clear communication plan, as well as development of a statewide, tiered healthcare system to respond to outbreaks of infectious disease. This report serves as an initial roadmap to developing a statewide system to respond to infectious diseases and improve the safety and well-being of Arizonans. In response to the recommendations, the Council identified and completed many deliverables in support of these charges."
Arizona. Department of Health Services
Humble, Will
2014-12-01
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Implementing Hospital Respiratory Protection Programs: Strategies from the Field
From the Scope: "The scope of this monograph covers ways that hospitals can build, implement, and maintain effective respiratory protection programs for the health and safety of their employees and patients. It is intended to be an educational document for RPP [respiratory protection programs] administrators and others who wish to learn about solutions to common problems associated with the implementation and management of a successful respiratory protection program. In addition, this monograph is intended to accomplish the following: [1] Highlight examples from hospitals that have improved their programs through leadership involvement and promotion of a safety culture; [2] Describe common training and fit testing challenges and potential strategies for overcoming barriers; [3] Share practical approaches to promoting effective communication, coordination, and collaboration; [and 4] Highlight currently available educational resources."
The Joint Commission
2014-12
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Hurdles to Herd Immunity: Distrust of Government and Vaccine Refusal
From the Abstract: "More children have been granted nonmedical exemptions from required vaccinations in recent years in the United States. While the majority of the population quietly benefits from high vaccination rates, there exists a small (but growing) raucous minority of opponents who refuse vaccination and are incredibly vocal in society. Underlying this minority antivaccine ethos is a sense of distrust of the government and in healthcare providers. This distrust influences where parents obtain their vaccine information and further serves as a filter that colors immunization resources from healthcare providers or government agencies with a layer of skepticism and suspicion. Parents who distrust the government or their healthcare providers are less likely to vaccinate their children fully and more likely to seek out complementary/alternative medicine (CAM) practitioners or antivaccine websites for vaccine information. These antivaccinators do not change their decisions about vaccination when confronted with scientific information on vaccine safety and the dangers of vaccine-preventable diseases. New modalities for delivering pro-vaccine messages need to be researched. Innovative techniques to reach this distrustful population could include vaccine negotiation training for healthcare providers, specifically emphasizing the importance of gaining trust. Local initiatives to create parental peer advocate programs for vaccines through school Parent-Teacher Associations, professional groups, or religious groups could better access the antivaccine population. Increased collaboration between public health officials and CAM practitioners may also improve vaccination rates."
Duke University
Lee, Charlotte
2014-12
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MMWR: Morbidity and Mortality Weekly Report, March 15, 2013
The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC). [It] is the agency's primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. This issue of MMWR contains the following: "Mobile Device Use While Driving -- United States and Seven European Countries, 2011"; "HIV Infection Among Heterosexuals at Increased Risk -- United States, 2010"; "Eligibility and Enrollment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) -- 27 States and New York City, 2007-2008"; "Update: Severe Respiratory Illness Associated with a Novel Coronavirus -- Worldwide, 2012-2013"; "Announcement: Brain Injury Awareness Month -- March 2013"; "Erratum: Vol. 62, No. 7"; and "QuickStats: Percentage of Adults Aged ≥18 Years Who Often Felt Worried, Nervous, or Anxious, by Sex and Age Group -- National Health Interview Survey, United States, 2010-2011". Notifiable Diseases and Mortality Tables from this issue can be accessed at the following link [http://www.cdc.gov/mmwr/index2013.html]
Centers for Disease Control and Prevention (U.S.)
2014-11-21
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WHO: Ebola Response Roadmap Situation Report [October 31, 2014]
From the Summary: "A total of 13,567 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in six affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States of America) and two previously affected countries (Nigeria, Senegal) up to the end of 29 October. There have been 4951 reported deaths. The cases reported are fewer than those reported in the Situation Report of 29 October, due mainly to suspected cases in Guinea being discarded. Following the WHO [World Health Organization] Ebola Response Roadmap structure, country reports fall into two categories: 1) those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and 2) those with or that have had an initial case or cases, or with localized transmission (Mali, Nigeria, Senegal, Spain, and the United States of America). An overview of the situation in the Democratic Republic of the Congo, where a separate, unrelated outbreak of EVD is occurring, is also provided. "
World Health Organization
2014-10-31
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WHO: Ebola Response Roadmap Situation Report [October 29, 2014]
From the Summary: "A total of 13,703 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in six affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States of America) and two previously affected countries (Nigeria and Senegal) up to the end of 27 October. There have been 4,922 deaths. The outbreaks of EVD in Senegal and Nigeria were declared over on 17 October and 19 October 2014, respectively. EVD transmission remains persistent and widespread in Guinea, Liberia, and Sierra Leone. All administrative districts in Liberia and Sierra Leone have now reported at least one confirmed or probable case of EVD since the outbreak began. Cases of EVD transmission remain lowest in Guinea, but case numbers are still very high in absolute terms. Transmission remains intense in the capital cities of the three most affected countries. Cases and deaths continue to be under-reported in the outbreak. Of the countries with localized transmission, Mali, Spain and the United States of America continue to monitor potential contacts. In Mali, a 2-year-old girl died of Ebola on 24 October, after travelling with her grandmother from Guinea. The case makes Mali the sixth West African nation to be affected in the current Ebola outbreak. In Spain, the single patient with EVD tested negative for the disease for a second time on 21 October. Spain will be declared free of EVD 42 days after the date of the second negative test, unless a new case arises during that period. In the US, two health-care workers have tested negative for Ebola for the second time, and have been discharged from hospital. Another health-care worker remains in isolation and is receiving treatment."
World Health Organization
2014-10-29
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Ebola Outbreak: Quarantine and Isolation Authority [October 28, 2014]
"Recent quarantine policies announced by several states, including New York and New Jersey, for travelers arriving from areas affected by the outbreak of Ebola Virus Disease have raised legal and constitutional questions about federal and state authority to order quarantine and isolation measures. Both the federal and state governments have authority to impose isolation and quarantine measures to help prevent the spread of infectious diseases. While the terms are often used interchangeably, quarantine and isolation are two distinct concepts. Quarantine typically refers to separating or restricting the movement of individuals who have been exposed to a contagious disease but are not yet sick. Isolation refers to separating infected individuals from those who are not sick. Historically, the primary authority for quarantine and isolation exists at the state level as an exercise of the state's police power in accordance with its particular laws and policies. Generally, state and local quarantines are authorized through public health orders, though some states may require a court order before an individual is detained. The Supreme Court has indicated that at least where Congress has not taken action, it is 'well settled' that states may impose quarantines to prevent the spread of disease. Nevertheless, the federal government has jurisdiction over interstate and foreign quarantines. The Centers for Disease Control and Prevention (CDC) is authorized to take measures 'to prevent the introduction, transmission, or spread of communicable diseases from foreign countries into the States or possessions, or from one State or possession into any other State or possession.'"
Library of Congress. Congressional Research Service
2014-10-28
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Illinois Department of Public Health - Isolation and Quarantine Review and October 24 Guidance Regarding Travelers from Ebola-Outbreak Affected Countries
From Isolation and Quarantine Guidance: "IDPH [Illinois Department of Public Health] issued guidance on Friday, October 24th (attached), clarifying risk categories and restrictions for travelers from Ebola-Outbreak Affected Countries, and asymptomatic contacts of EVD [Ebola Virus Disease] patients (including health care workers). Beginning October 24th, these individuals that fall within the definition of 'high-risk' shall be subject to a mandatory (involuntary) quarantine. This quarantine shall confine the individual to a health care facility (when already admitted) or the individual's residence/destination; whichever destination is appropriate and least restrictive. This mandatory (involuntary) quarantine is to be issued by the certified local health department pursuant to the authority described in the DPH [Department of Public Health] Act (20 ILCS [Illinois Compiled Statutes] 2305/2(c)). Within 48 hours of issuing a mandatory (involuntary) quarantine order for a high-risk individual, the certified local health department shall seek a court order pursuant to the terms of the DPH Act. Please note this mandatory (involuntary) quarantine only applies to high-risk individuals, not to all returning travelers and not to all health care workers providing care for an individual with symptoms consistent with EVD. Upon filing a petition requesting a court order, the certified local health department must serve a notice of the hearing to the person(s) being isolated or quarantined at least 24 hours before the hearing. Certified local health departments are encouraged to reach out to discuss these procedures with their State's Attorney's Offices. The county via the local State's Attorney will be the entity seeking the court order, not the Department. Certified local health departments and local State's Attorney's Offices should be prepared in the event a court would require testimony from local, on-site medical personnel."
Illinois. Department of Public Health
Hasbrouck, LaMar
2014-10-27
